Abstract
OBJECTIVE: To investigate the effectiveness and pain improvement of self-directed rehabilitation (SDR) using a wearable motion tracker system (WMT) with smartphone application feedback after total knee arthroplasty. DESIGN: A randomized controlled trial in institutional practice enrolled female patients who had undergone total knee arthroplasty. The experimental group was instructed to perform self-directed rehabilitation using the WMT device (WMT), and the control group performed self-directed rehabilitation protocol under physiotherapist supervision (SDR) according to discharge education at home with regular outpatient visit. 24 and 25 patients in the experimental and control group were analyzed. Knee ROM, WOMAC, EQ-5D-5 L, KOOS, and motion tracker gained gait speed, and gait ROM was assessed at preoperatively, and 3,6, 12 weeks postoperatively. RESULTS: In the mixed-effect model analysis, significant differences between the groups were observed in WOMAC pain, stiffness, function subsets, and EQ-5D-5 L, KOOS stiffness, pain, and activities of daily living subsets. WOMAC stiffness and EQ-5D-5 L scores were lower at 3week, and KOOS stiffness scores were higher at 6week in the experimental group. Lower WOMAC and higher KOOS stiffness scores were observed at 12week in the experimental group. (95% CI for all). CONCLUSIONS: WMT-supported rehabilitation provided significant benefits in reducing postoperative pain and stiffness, and improving knee function and quality of life in the early postoperative period. Many of the results were superior to the level in conventional SDR with intermittent physiotherapist guided rehabilitation. TRIAL REGISTRATION NUMBER: KCT0010323 Clinical Research Information Service (CRIS), Republic of Korea, 2025.03.20 : Retrospectively registered https://cris.nih.go.kr/cris/search/detailSearch.do?seq=29333%26;search_page=M%26;search_lang=%26;class_yn= .